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Patient access areas are seeing more procedures requiring authorization, a surge in the number of insured patients, and more clinical requirements from payers. All of these factors make an increase in claims denials and much lost reimbursement very likely.
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Prior to the advent of the inpatient prospective payment system (IPPS), the discharge planning process was simpler and slower. Patients generally stayed in the hospital until they were well and then went home.
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Implementation of ICD-10 has been postponed until Oct. 1, 2015, and all claims submitted after that point must use the new coding system.
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The Centers for Medicare & Medicaid Services (CMS) has announced a pause in the Recovery Auditor program while it develops new contracts with the auditors, and so the auditors can complete all claims reviews before the current contracts expire.
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After St. Rose Hospital in Hayward, CA, started its readmission reduction program, the community hospitals 30-day readmission rate for all diagnoses dropped by 37% and the 90-day readmission rate declined by 43%.
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In February, Evelyn Lynch, a 70-year-old nurse at Brookdale Hospital in Brooklyn, NY, was removing a catheter from a patient when he suddenly knocked her to the ground and began beating and stomping on her.
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Reams of surveys have documented the frequency of verbal and physical assaults in the nations emergency rooms.
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The risk of violence simmers in behavioral health units across the country but it is possible to defuse that tension and prevent incidents through frequent community meetings between staff and patients.
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After hospital workers encounter workplace violence, their medication use goes up, but there is no change in their visits to mental health counselors, according to a new study. Instead, they may be receiving much-needed emotional support from employee assistance programs.
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For the past 10 years, the United States has been wrestling with a resurgence of pertussis as outbreaks strike in different states. In 2013, cases subsided in most of Minnesota, but spiked in Texas and North Carolina, for example. California reported 2,372 cases, 132 hospitalizations and one death of a two-month-old.
